Triage based managed health kiosk system

ABSTRACT

The present invention is directed to triage based managed health kiosk systems, and more particularly to facilitating a more automated approach to emergency triage situations through use of kiosk systems in combination with on-site health care professionals. The disclosed system allows a user to answer automated health assessment questions, provide health data, and consult with an on-site health care professional, and then receive a health care professional authorized triage assessment of the extent and relative urgency of care needed.

CROSS-REFERENCES TO RELATED APPLICATIONS

This is a utility patent application, taking priority from provisionalpatent application Ser. No. 61/070,309, filed Mar. 21, 2008.

BRIEF DESCRIPTION OF THE INVENTION

The present invention is directed to triage based managed health kiosksystems, and more particularly to facilitating a more automated approachto emergency triage situations through use of kiosk systems incombination with on-site health care professionals.

STATEMENTS AS TO THE RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSOREDRESEARCH OR DEVELOPMENT

Not applicable.

REFERENCE TO A “SEQUENCE LISTING,” A TABLE, OR A COMPUTER PROGRAMLISTING APPENDIX SUBMITTED ON A COMPACT DISK

Not applicable.

BACKGROUND OF THE INVENTION

Publicly available self-directed health care stations have beenavailable at varying levels of complexity and sophistication for manyyears. Do-it-yourself blood pressure monitoring stations are oftenavailable in or near retail pharmacies, doctors' offices, corporatefacilities, and retail centers such as shopping malls and strip malls.

The field of medicine has long employed health care screening todiagnose and track patients' health. An annual physical examination is awell-known part of patient medical care.

Hospitals, health clinics, and pharmacies, in addition to having anactive role in supplying medical supplies and pharmaceuticals, haveactively promoted various health care screenings and wellness programs.Screening programs are sometimes offered with the help of other healthcare providers or coordinated on a national basis with groups such asthe American Lung Association, the American Diabetes Association, andthe American Podiatric Medical Association.

Health care screening devices in hospitals, physician's offices,businesses, and the like, in combination with the growing number of homediagnostic kits that are available have increased the efficiencies inhealth care delivery. Large drug store operators have increasinglyencouraged individual testing by making available in-store diagnostictesting devices. For example, customers waiting to fill a prescriptionare often encouraged to check their blood pressure while they wait witha blood pressure measurement/screening device, and pharmacists who fillhigh-blood pressure prescriptions to customers often encourage theircustomers to regularly check their blood pressure. Such customers oftenuse blood pressure measurement/screening devices that are provided inthe drug store.

To increase attention to the importance of health care screening, manymedical and health product retailers offer medical tests and screeningfor consumers visiting their stores. Most commonly, the retailers checkcholesterol levels and blood pressure, although other tests areavailable. In addition to supplying a valuable customer service,in-store testing effectively educates consumers about various healthproblems that can be better managed by a regimen that includesmonitoring. Typically consumers are unaware of the technologicaladvances that have made health care screenings feasible in the clinical,retail, and home settings. Pharmacies and drug retailers have generallyfound that the availability of screening test devices in the storesincrease traffic and cultivate customer loyalty.

The offer of in-store testing commonly is highly popular among customersand greatly boosts the number of people visiting the store. In-storetesting is valuable for positioning stores as health and wellnesscenters as well as retailers of health care products. In-store testingincreases sales since a consumer who learns of a health problem throughscreening in the store has some likelihood of purchasing a home test kitto monitor the problem. For example, a customer who discovers a problemwith high blood pressure through an in-store test is a likely candidateto purchase a home blood pressure testing kit.

In-store health care screening expands the pharmacist's role in patientcare through education. Test device manufacturers have advanced thedesign and functionality of products to simplify usage and improveaccuracy. The challenge for further improvements in health carescreening is to educate consumers about the need for medical tests, anddemonstrate that many tests are effectively performed by publiclyavailable devices or at home.

A present concern is that health screening is performed on aninsufficient segment of the population to efficiently prevent or treatailments. Other concerns are that health screening is too costly,limited in scope, and time-consuming both for individual patients andhealth care providers. Despite these deficiencies, a strong awarenessexists of a need and desire for improved health screening procedures andequipment. Health care providers, insurance companies, and employersthat ultimately pay for health care have encouraged development andusage of improved, accurate, yet economic health screening facilitiesboth for treatment and prevention of health care problems.

Generally, individual doctors and small groups of doctors haveinsufficient capital to maintain complete health screening facilities.Even if more health care providers were suitably equipped, typicallyonly a small portion of the population utilizes health screeningfacilities due to time constraints, cost considerations, and/or generalapathy.

Health care costs are a major concern in this day and age in the UnitedStates. Some commentators point out that our current national healthcare policy does little to incentivize preventative medicine and insteadincentivizes treating major problems, at a high cost, somewhere down theline. More and better screening of patients, early and often, increasesthe likelihood of finding a problem early and treating it inexpensively;as opposed to finding it later and spending significantly more tocorrect a major health problem.

As health care costs go up, a doctor's time is also more valuable. Itwould be advantageous, and would save money, to allow doctors to seemore patients each day.

What are needed are health screening devices, facilities, and methodsthat can be placed in locations that are convenient to health carecustomers. Suitable locations include retail outlets such as pharmaciesor drug stores where customers already make health care purchases, butalso may include medical offices, clinics, emergency rooms, hospitals,convalescence and elderly care facilities; work places (such as officesor factory sites), college dormitories, and the like. Health screeningdevices, facilities, and methods that are convenient, efficient, low incost, and professionally accurate in screening health care data wouldgreatly improve the general population's health.

Health screening facilities do exist. Bluth et al., U.S. Pat. No.6,692,436 describes a health care information system including bloodpressure monitoring and body weight monitoring. Such systems, however,do not take advantage of more modern technologies. More and more medicaltesting devices have become cheaper and easier to manufacture, makingtheir absence from such screening facilities inefficient.

Local health screening facilities that take advantage of various medicaltesting device efficiencies and improved twenty-first centuryinterconnectivity through the use of broadband Internet would beadvantageous.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING

FIG. 1 illustrates the high level architecture of a managed healthsystem or community-based health information and screening kiosk systemin accordance with the research database embodiment of the presentinvention.

FIG. 2 illustrates a user-data screen from the perspective of a remotelylocated health care professional in accordance with the presentinvention.

FIG. 3 is a plan view of a community-based health information andscreening kiosk system in accordance with the triage embodiment of thepresent invention.

FIG. 4 is a perspective view of the user desk portion of a communitybased health information and screening kiosk system in accordance withthe present invention.

FIG. 5 is a perspective view of the front area of a community-basedhealth information and screening kiosk system in accordance with thepresent invention.

DETAILED DESCRIPTION OF THE INVENTION

The following description is directed to a community based managedhealth system that includes a managed health kiosk system, a securitysystem for the kiosk system, a research database system associated withthe kiosk system, a prescription dispensement system for the kiosksystem, a kiosk system for solicitation of patients for medical testingand health studies, and a triage based kiosk system.

The systems, and related methods, facilitate measurement, recordation,analysis, and communication of various health-related data belonging toa patient, many individual patients, or a specific group of patients.The system and/or apparatuses are able to measure, record, analyze, andcommunicate data from non-invasive and invasive testing from a varietyof input devices. The herein disclosed invention can be a system, amethod, or an apparatus, and involves a combination of computer andmedical device hardware, computer and input device software, andphysical kiosk hardware. The embodiments, however, will mostly bereferred to as managed health systems or kiosk systems throughout thisapplication for ease of reading.

The disclosed systems combine two or more input devices with one or morepersonal computers plus Internet connectivity to create a kiosk that apatient is able to use to further the patient's understanding andknowledge of his or her own health and to obtain professional healthservices. The system is able to utilize up to 24 external devicesinteracting with one or more personal computers and necessary softwareto measure, record, and/or analyze a patient's blood pressure, weight,heart rate, pulse oximetry, spirometry, resting metabolic rate, glucose,cholesterol, urinalysis, and other conditions. In other embodiments itmay even be possible to utilize more than 24 external input devices.Each of these input devices receive pieces of health information from auser and facilitate recordation of the pieces of health information.Each will be explained below.

The herein disclosed managed health system or community based healthinformation and screening kiosk systems can be equipped with a healthrisk appraisal platform. Such a platform can be utilized in many relatedways. For example, a health risk appraisal platform can be used in ahospital emergency room for triage analysis. In such an application, atriage nurse will interact with the community based managed healthsystem kiosk system and with the patient to determine the relativeurgency of the patient's situation and what exactly may be afflictingthe patient. In another example application, a community based healthinformation and screening kiosk system can be located at an employer'soffices or plant. In such a situation, employees are able to easily keepabreast of many of their own health risks and needs without having totake time off work to see an off-site doctor directly. Employers too maytake advantage of the on-site kiosk to monitor and analyze aggregate(non-patient identifiable) health status data. In yet another exampleapplication, a community based health information and screening kiosksystem can be located in remote or under-serviced geographic locationsto allow patients to receive medical testing, information, and advicewithout having to travel long distances to see competent health careproviders. Finally, aggregate data from one or more networks ofcommunity based health information and screening kiosk systems can beanalyzed and then utilized to establish or monitor populations orgeographic areas with greater disease risks.

The community based health information and screening kiosk system may beset up in different ways depending on the desired application. Forexample, at a minimum, different prompts will be displayed to anemergency room triage patient, compared to an employee using a companyon-site kiosk to obtain a monthly health evaluation. It may also be thatentirely different combinations of medical testing and input devices areappropriate for each of the different community based health informationand screening kiosk system applications. All such input devices andsoftware variations will be explained below. As will be apparent tothose skilled in the art, all such permutations are possible and areintended to be covered by this disclosure. If certain embodimentsdescribe certain permutations, it is because such permutations appear tobe either a minimum for the desired application, or it is because suchpermutations appear to be ideal for the desired application. But inevery instance, all such permutations are intended to be within thescope of this disclosure.

One embodiment of the herein disclosed community based healthinformation and screening kiosk system includes a health risk appraisalplatform. This platform is able to display to a user a series ofcomputer screens which present a set of health data, including healthinformation and health assessment questions designed to obtain healthand lifestyle information from the user to enable the platform to assesshealth risks.

The health risk appraisal system can be either a platform or a specificsoftware program. It is possible to design the overall community basedhealth information and screening kiosk system so that an individual usercan pick and choose how the appraisal system elicits health,biographical, and lifestyle information from a user. In such asituation, the owner of the overall system (the kiosk) would be able toselect questions from a predetermined list or may be able to write hisor her own questions. Such an owner may also be able to choose the orderin which such questions are presented. Such a platform is fullyadjustable, editable, and customizable by a sophisticated owner,allowing unlimited options for the owner to elicit patient/userinformation. It is also possible to design the disclosed health riskappraisal system as a pre-packaged software program, or as several fullythought-out, pre-packaged software programs.

The appraisal system is able to utilize either a touch screen or akeyboard and mouse/trackball setup, or even a combination of a touchscreen and a keyboard. These devices can be referred to as controldevices. With a touch screen built into the system, a user is able toselect answers to multiple-choice type questions directly onscreen. Witha keyboard and mouse as user-input devices for the system, a user isable to more easily personalize a response. Detailed answers could betyped out as phrases, full sentences, full paragraphs, or even multipleparagraphs. As information will be stored digitally and/orelectronically, there is no inherit need to limit space for a user orpatient's explanation of health related information. To reduce the needto sterilize the user touched components of a kiosk system, voicerecording or recognition software could be utilized so a user is able tospeak answers to questions.

As discussed above, the system can be built pre-programmed with packagedhealth risk assessment question sets. There are many such health riskassessment tests available in the medical and health community. One suchexample is the PHQ-9 (Patient Health Questionnaire) assessment test.This is a nine question, relatively detailed test. The PHQ-9 is apowerful tool for assisting primary care providers in diagnosingdepression as well as selecting and monitoring treatment, and is baseddirectly on the diagnostic criteria for major depressive disorders inthe Diagnostic and Statistical Manual Fourth Edition (DSM-IV). There aretwo components of the PHQ-9: assessing symptoms and functionalimpairment to make a tentative depression diagnosis; and deriving aseverity score to help select and monitor treatment. Many other suchpre-packaged health assessment tests are available and can easily beformatted for use in the disclosed health risk assessment system.

Aside from highly interactive embodiments of the disclosed healthinformation and assessment system, the disclosed invention may also beutilized by a user, or optimized by the owner for specific or knownusers, as a type of health information encyclopedia. In this sense, thesystem may be utilized like a personal computer accessing a specificwebsite. A user is able to navigate a complex combination of healthinformation screens and menus that allow the user to find information onany health-related topic that may be of interest.

Such an encyclopedic embodiment may be able to display all sorts ofhealth related data. For example, the system may be able to provideinformation on various vitamins, minerals, drug active ingredientlistings, drug use directions, drug interaction warnings. The system maybe able to provide videos on preventative and/or healthy livingpractices like exercise, ideal sleep patterns, and health-sustainingdiets. The system may also provide local directories of community healthcare providers and services in the user's hometown. All such healthinformation can be locally stored at the kiosk system on a hard drive oron a standard media format such as a flashdrive, a CD, a DVD, etc, orremotely at a personal health record storage system or a remotelylocated website.

The disclosed health information and assessment system may be able todisplay information, health questionnaires, health assessments, andother important information in practically any language. Such an abilityto display in multiple languages is obviously of value, even if suchsystems are only used in the United States. According to a 2006 AmericanCommunity Survey conducted by the United States Census Bureau, Spanishis the primary language spoken at home by over 34 million people aged 5or older. Obviously, it is desirable to obtain, and dispense, accuratehealth and fitness information with the disclosed system. Providinghealth information and presenting health questions in a user's nativelanguage will help to increase a user's understanding and ensure thatmore accurate information is provided to the user. This is easily donewith the disclosed system.

The number of available display languages is only limited by thesoftware components which are used to build the system, and by theinvestment that an owner is willing to make having health informationand questions for the system owner translated.

Aside from display considerations, how the system stores information isof great importance. The health information and assessment system may beable to provide a rough instantaneous translation of information inputby a non-English speaking user (or a user who speaks English, but forconvenience has chosen to interact with the system in his or her ownnative language). In this way, user-supplied non-English answers toopen-ended questions (as opposed to multiple-choice questions) can beprocessed and automatically translated into English before being sent tomedical professionals such as nurses and doctors. Such processing ofmultiple-choice type assessment questions is obviously much more easilyhandled—both questions and each available answer can be pre-translatedso that a user is essentially answering each question in all availablelanguages at once.

Instantaneous automatic translation, which is referred to as machinetranslation in the field, is not today as accurate as human translation.Nevertheless, machine translation is available that does a passable jobthat may be good enough for emergency-type situations. Such machinetranslation can be assisted by producing the original text to betranslated in what are referred to as controlled natural languages.Controlled natural languages are subsets of natural languages, obtainedby restricting grammar and vocabulary in order to reduce or eliminateambiguity and complexity. The health information pages and theassessment questions can be originally drafted in controlled, orsimplified, English so that it can later be automatically machinetranslated by the system. Non-English users can be advised to use simpleand straightforward sentences, while avoiding slang, when inputtingtheir answers.

Information obtained by the health information and assessment systemabout a user is stored for the user's convenience, for use by healthcare providers, and for research purposes. The health information issecurely stored so that there is no fear of unauthorized disseminationof user health information. The stored information is a combination ofuser-input answers to health assessment questionnaires and results fromvarious intrusive and non-intrusive health analysis procedures, whichwill be described in detail below (cholesterol testing, for example).These may be referred to as pieces of health information and pieces ofpersonal identification information (or personally identifyinginformation). This combination of user health information is referred toas a PHR, which stands for Personal Health Record.

The PHRs can be stored in a number of ways. An exemplary embodiment ofsuch a health information storage system is where the PHR, gathered at ahealth information and assessment kiosk system, is transmitted to astorage and processing server located off-site, meaning at a geographiclocation different than where the kiosk itself is located. Thetransmission of PHRs may be accomplished through use of a privatenetwork, or a public network, such as the Internet. When a publicnetwork is utilized, the PHRs are encrypted or otherwise secured so theprivacy of the user's health information is maintained, such as throughthe use of secure socket layer (SSL) formatting, as is known in the art.When a public network, such as the Internet, is utilized the PHRs may bestored at a nation-wide hub, or multiple regional hubs, to reducestorage and transport costs, to facilitate access to the informationfrom authorized sources, and to provide a level of redundancy to avoid acatastrophic loss of the information. It is also possible for the userto dictate where his or her PHR should be stored. For example, thirdparties may setup PHR deposit websites configured to receive, store, andmake available a user's PHR created by the herein disclosed kiosksystem. Or, it may be possible for the user to dictate that suchinformation be sent, via email or ftp or another appropriate electronicinformation transmission system, to user's website or personal computerfor storage as the user sees fit.

Regardless of where a PHR is stored, the PHR is ideally always availablefor review by the user at a later date. For example, once a user hasinput his information at a kiosk system, that user can later access theinformation at the same kiosk or at another kiosk at another geographiclocation. The security measures of the present invention ensure that auser attempting to access a PHR is in fact the correct user, but suchinformation is always available once input.

When stored for research purposes, health information is aggregated andnot stored like PHRs. With aggregated information unlike a PEAR, healthinformation is not grouped together by user. Instead, data from eachdistinct test or question is grouped with other user's data in anaggregated database to allow for study of trends throughout populations.Aggregated data from multiple users, or groups of users, may beresearched, but a specific individual's PHR is not accessible by theresearcher(s). One exemplary way of doing this is to assign each user anidentification number, and then assign that number, instead of theuser's name, to each piece of health data or health information obtainedfrom that user. Authorized entities (researchers) studying theaggregated data would be unable to connect an identification number backto the user's name, thus preserving a user's confidentiality andprivacy. Authorized entities would, however, be able to sort theaggregated database by various appropriate parameters, such as: disease,treatment, geographic regions, user demographic (user age, gender,ethnicity, etc.) or classification (employee type, etc.). The researchdatabase may be capable of extracting such parameters, includingdemographical and/or classification information, from the personallyidentifying information so that the various pieces of health informationcan be organized or sorted by the parameters without linking the piecesof information to individual users' names or identities.

FIG. 1 illustrates a layout of the herein disclosed community basedhealth information and screening kiosk and research database system.Kiosk and research database system 100 includes a kiosk system 102 thatis connected to both the user's PHR 104 and research database 106 over anetwork, such as the Internet, 108. When a user uploads his or herhealth data, it is recorded and analyzed at kiosk system 102,simultaneously incorporated into the user's PHR 104 and incorporated (ina non-personally identifiable way) into research database 106. Remotelylocated health care professionals 110 would have the ability to accessthe user's PHR 104 if the user allows such access (dotted line at 112represents user's ability to control when and how health careprofessionals can access the user's information). Dotted line 114represents that research database 106 can be accessed by remote healthcare professionals, including researchers world-wide, and can bemanipulated in various ways. For example, aggregate user data can befiltered by disease, by treatment, by user statistics/demographics (suchas user age, gender, etc), etc.

A user's PHR, and the individual data points being stored for researchin the aggregated form, are maintained with the user's confidentialityand security in mind. All record storage meets or exceeds privacystandards, including HIPAA (Health Insurance Portability andAccountability Act), a federal statute governing maintenance ofelectronic health records.

In addition to security means for securing transmission of data, manyphysical security means can be used at the kiosk site to providesecurity. Up to five levels of security can be implemented in thedisclosed health information and assessment system. The securitymeasures can include the following identity verification devices: athumbprint scanner, a signature pad, use of photo identification cards,an access card with a 16-digit magnetic stripe, and a 4 digit PIN(Personal Identification Number) set by the user. These identityverification security devices will be discussed below. The five levelsof security can be combined in various ways. For example, a kiosk systemcould require at least two forms of identification (a matchingthumbprint and a PIN number, for example) from a user before the user isable to access a PHR through the kiosk. The five levels of security canof course be combined in other ways and this specification intends toinclude all such permutations.

As described above, the herein disclosed health information andassessment system has the ability to store aggregated user healthinformation and data for analysis. Such analysis can be contracted outto a third party, or such analysis can be part of the entire system. Forexample, a company that chooses to locate a health information andassessment kiosk system on its premises can mandate, or suggest, thatits employees regularly complete a health assessment questionnaire.Results from all company employees can be analyzed in aggregate form toevaluate the company's employee's overall health and fitness levels, andcan be used to spot trends, both positive and negative.

Such an analysis can be done on aggregate data for many purposes. Forexample, such an analysis may assist a company in comparing the healthof its employees from office to office or from one production facilityto another production facility. Other exemplary analyses that can bedone include assessing health status data according to employeeclassification and determining frequently occurring diseases orailments.

The disclosed health information and assessment system is able toperform more generalized employee surveys, beyond health assessments.For example, employers who place a health information and assessmentkiosk system at their workplace can ask employees to answer questionsregarding their job satisfaction and/or to provide suggestions forcompany improvement. The kiosk system can be useful in this regard forcompanies whose employees are not regularly interacting with computersand so can not otherwise easily take automated surveys. As with healthassessment questionnaires, employee surveys can be designed by thecompany itself or can be chosen from many prepackaged employees surveysavailable in the field.

If a company's employees do not have regular access to a computer, thehealth information and assessment kiosk system can also provide Internetaccess to employees. Essentially, because the kiosk system incorporatesat least the major components of a personal computer, the kiosk systemcan easily accomplish many common personal computing tasks, such as wordprocessing, email, and Internet browsing. A company may find it usefulto provide the kiosk system for these personal computing uses if theiremployees do not otherwise have regular access to a personal computer.It also is possible for the company to limit the available webpages thata user can navigate to while using the kiosk system for Internet-browseractivity. A company could, for example, limit Internet browsing to onlythe company's own website. Or, the company could set up its own customfirewall, or chose a pre-packaged firewall, to limit employees to onlybrowsing those sites pre-approved by the company.

Due to the large amount of data collected, especially when video isutilized, many of the applications herein disclosed require some form ofnetwork connectivity, but this can be both internal to and external tothe kiosk system. The kiosk system itself may be connected to a networkthrough a network connection, which may be a standard 10/100 Mb Ethernetjack (RJ45) through a local LAN network or a direct connection to astorage system that is resident within the kiosk system, physicallylocated nearby, or remotely located. Alternatively, kiosk systems may beequipped with 802.11a/b/g devices for wireless connectivity, withstorage being nearby or remote. Other methods or devices for connectingwith a network are known in the art and may also be appropriate.

As described above, the health information and assessment system is ableto accurately obtain a user's vital signs through a combination ofinvasive and non-invasive testing. The data from the various invasiveand non-invasive testing procedures can be stored as part of the user'sPHR, and it can be transmitted to health care professionals at othergeographic locations. In many situations, such as prior to or followinga major medical procedure, a doctor would like to closely and accuratelymonitor a patient's vital signs, such as body temperature, pulse orheart rate, blood pressure, and respiratory rate, without requiring thepatient to go to a doctor's office or a medical facility. All of thesevital signs, and many more health metrics, can be monitored remotelyusing the health information and assessment system, which may be locatedat a community clinic, at a drug store, at a grocery store, or manyother convenient locations close to a patient's home. A doctor or nurseis then able to receive an electronic transmission of the desired vitalsign data, and other data, so that the doctor or nurse can monitor thepatient's vital signs remotely, and even communicate directly with thepatient while the kiosk system is in use, as further described below.

Such a remote monitoring setup is desirable for many reasons. The doctoror nurse is able to remotely monitor several patients, possibly at thesame time, from one centralized location without having to travel.Conversely, the patient is able to avoid the need to travel, what may bea long distance, to see the doctor or nurse, and can instead travel,what may be a short distance, to a local health information andassessment kiosk system.

FIG. 2 illustrates a user-data screen 200 as displayed to a remotelylocated health care professional in accordance with the presentinvention. When a user is interacting with a remotely located healthcare professional, the user's video image 202 and the user's health datacan be simultaneously displayed to the professional. User-data screen200 may include live video 202 of the user on one portion of theuser-data screen 200, include wave-form user data 204 (blood pressurereadings, for example) on another portion, textual user information 206(personal information such as name, age, etc, for example) on anotherportion, and possibly further user data 208 on another portion. In thisway, a remotely located health care professional can fully interact withthe user seated at a kiosk system. The remotely located health careprofessional may be able to select which pieces of health informationare displayed by user-data screen 200. Additionally, the user-datascreen 200 may be combined with a health care professional video camerato capture a video image of the health care professional, which then maybe displayed to the kiosk user. This user interaction with a remotelylocated health care professional is sometimes referred to as telehealthin the medical community. The herein described kiosk system enablesgreatly enhanced telehealth because live patient/user video, real timevital sign readings, and additional detailed user health information canbe combined with traditional voice interaction (a user communication anda health care professional communication can be sent back and forthbetween the kiosk system and the remotely located user-data screensystem) to allow health care professionals to conduct appointments,screenings, and diagnoses over long distances easily and efficiently.

The herein disclosed community-based health and screening kiosk systemcan also act as a community, or even a larger geographic area (such as anation-wide), health analysis tool over a long term time frame. Forexample, the data collected from users and patients can all be storedeither locally or remotely at a centralized location as described inFIG. 1 above. This information is aggregated so that it is no longeridentified with the individual who provided the data. This informationcan be accumulated over long periods of time from a vast number of usersor patients. All this aggregated health data can be very valuable to thegreater medical community. The data can be analyzed and trends can beidentified over time.

An additional application of the herein disclosed kiosk systems is toprovide live video for verbal discussions between users and remotelylocated doctors. This application creates the opportunity for automatedprescription drug dispensement from the kiosk system. A remotely locateddoctor can view the patient, talk to them about their issues and needs,and obtain all the health data he or she needs to legally and ethicallywrite a drug prescription for the patient. The kiosk system may beequipped with several of the most widely prescribed drugs in anautomated dispensing device. Such auto-dispensement devices are known inthe art, but have never previously been combined with a real-time remotehealth assessment and analysis system. Existing dispensement devicesmade by companies such as QUIQMED, PHARMACY AUTOMATION SYSTEMS, andINSTYMEDS can be advantageously combined with the herein disclosed kiosksystems to produce a community based managed health kiosk andprescription dispensement system. Such commercial drug dispensers, andtheir equivalent, may be capable of measuring a prescribed amount of theprescription drug and then bottling this prescribed amount in a consumercontainer, such as an industry standard cylindrical plastic container.Alternatively, such prescription dispensement devices may dispenseblister packs, containing pro-dosed amounts of the prescription drugs,as is known in the art. It may be additionally possible to attach apayment system to the managed health kiosk and prescription dispensementsystem. Such a payment system may be capable of receiving payment bycash or by credit or debit card, as is well known in the art.Alternatively, the kiosk system can be combined with a prescriptionprinting device, which may be a standard computer printer, for printingindustry recognized drug prescriptions. Or, the kiosk system can belocated in a commercial or public pharmacy facility, in which case thekiosk system may be capable of receiving the drug prescription from theremotely located health care professional and transmitting it to thepharmacy facility, where the prescription can be filled.

A further application of the herein disclosed kiosk system is in thesolicitation of medical testing and studies volunteers. As described,the kiosk system is able to measure and record all sorts of healthinformation of users. Once a health assessment has been performed on auser, the kiosk systems can go one step further and compare the user'sindividual health to databases of on-going or upcoming medical tests andstudies. The medical community has a difficult time finding testingsubjects for very specific tests because there is a disconnect betweenthe medical professionals looking for test subjects and the people withthe diseases and conditions they are looking for. Once a user completesa health screening at the kiosk system, however, he or she can beimmediately made aware of upcoming tests and/or trials that might beappropriate for that user. The user can be shown these tests and trialson user-display screen 406. Going further, the user can then direct thekiosk system to send, over the kiosk system network 108, an applicationfor the test and/or trial.

As described above, kiosk systems may also be used in triage situations.In such situations, a kiosk system may be located in an emergency roomor the waiting room of a clinic, where patients can sit down (if theyare able to do so) and communicate with the kiosk system to provideinformation regarding their condition. An onsite nurse or other healthcare professional may then work with the kiosk system to determine theuser's relative health situation; i.e. whether and when the user needsprofessional care. As further described below, FIG. 3 illustrates a planview of a portion of a kiosk system designed for triage use. In additionto the user's monitor and input devices (user-display screen 406 is notvisible in FIG. 3, but keyboard 403 and signature pad 402 can be seenand indicate where the user would sit), triage kiosk 300 may have anadditional health care professional keyboard 303 and health careprofessional signature pad 302. Additionally, the health careprofessional may have his or her own health care professional monitor306, separate from user-display screen 406. Those skilled in the artwill recognize that a laptop PC, or standard stand-alone PC, could beused in place of health care professional keyboard 303, health careprofessional monitor 306, and/or health care professional signature pad302, in what may be referred to as a health care professional input anddisplay system. These health care professional input devices allow anon-site health care professional, such as a triage nurse, to monitor theuser's progress through a kiosk health assessment questionnaire, and sosign-off on (or deny) the results of such an assessment or completedquestionnaire. In other words, the health care professional can assessthe completed questionnaire and provide his or her health careprofessional authorization for a Final triage assessment.

In such triage situations, the kiosk systems can be combined with aprinter to print out situation-specific user-identifying labels. Thelabels may include a triage assessment and can be worn by the user toconvey the user's triage assessment to other health care professionalsworking in the emergency room or clinic.

FIGS. 2 through 5 illustrate many of the various embodiments of thedisclosed community-based health information and screening kiosk system.The kiosk system has many different components that can be used in manyof the different embodiments, but may not be needed in others. Hence, agreat variety of different permutations of the kiosk system, eachincluding different combinations of those components, could bedeveloped. For example, the kiosk system can include headphones, amicrophone, a keyboard, a card reader, a signature card, a thumbprintpad, a scanner, a privacy curtain, a release button, a camera, glucosemeter hook-up, a pulse oximeter, weight-scale, blood pressure monitor,invasive-testing inputs, a temperature sensor, and other testingdevices. These devices may then be combined with various other devices,such as a printer, an audio speaker, a video display screen, and/orInternet connectivity. Each of these devices can then be integrated intothe software platforms so that data received by the input device can beincorporated into a user's PHR and/or delivered in useful format to ahealth care professional.

A preferred embodiment of a kiosk system is described with reference toFIG. 4. The kiosk system of FIG. 4 has a user desk portion 400 thatincludes a number of different items, include headset 401, which may bea physical combination of headphones and a microphone, or the functionalcombination of a pair of headphones and a microphone separately mountedwithin the kiosk system. Headset 401 allows a user to communicate with ahealth care profession and hear audio information dispensed either froma remotely-located health care professional or from availablepharmaceutical encyclopedias and/or health information videos and thelike. Headset 401 could be comprised of a flexible band and wiring thatfeeds audio content directly into a user's ears through one or twospeakers held against the user's head by the band, while also beingcapable of receiving audio input by the user via a microphone. It couldalso be a standard telephone-type input/output device—having a unshapedhandheld plastic or metal piece that a user holds up to the side of hishead, while placing the speaker at the user's ear and the microphonenear the user's mouth. Headset 401 allows the user to interact withremote health care professionals by speaking a user voice communicationinto the microphone and by listening to a health care professionalcommunication through the headphones. Obviously, speakers mounted withinthe kiosk could be used in place of the headphones. The advantage tousing a headset is that it leaves a user's hands free to simultaneouslyuse other input devices, such as the keyboard or the pulse oximeter.

Signature pad 402 may be located on the user desk portion 400 in frontof, or slightly beneath, keyboard 403. Keyboard 403 is a standardalphanumeric keyboard that a user may use to input words, phrases,sentences, paragraphs, or even multiple paragraphs into the system.Keyboard 403 can additionally be utilized by deaf and/or hard-of-hearingusers to communicate in real time with health care professionals. Suchuser inputs, or responses, may be integrated into the user's PHR, may beused as part of an automated health assessment, and/or may betransmitted to a remote health care professional to be used as thehealth care professional sees fit. Keyboard 403 is generally a standardUnited States layout keyboard (QWERTY setup), but a foreign-languagekeyboard or keyboard setup may be substituted as needed in foreignlocations.

Signature pad 402 may be a standard signature pad for electronicallyrecording a user's signature. A user may be prompted to enter his or hersignature into signature pad 402. A user's signature may be used as asecurity measure, to compare with a previous signature in a user's PHR,or may be used in a legally binding way to create a contract or toacknowledge a doctor's warning, etc. Many commercial signature pads areavailable on the market, and most can be utilized in the disclosed kiosksystem. Such signature pads have a relatively small LCD, or equivalent,display screen, and a pen-like device that the user uses to write his orher signature on the small display screen. The movements of the pen-likedevice are recorded by the signature pad and then can be transmittedinto the kiosk system. An image of the user's signature can be stored atthe kiosk, or can be transmitted to remote health care professionals orto the user's remotely-stored PHR.

Thumbprint reader 410 may be located on the right side of the user-deskportion 400 of the kiosk system. Thumbprint reader 410 is a commerciallyavailable device for capturing the likeness of a user's thumbprint. Ifthe kiosk system is set up to utilize thumbprint reader 410 as anadditional security measure, a user may be prompted to insert his or herthumb into the reader, or to swipe his or her thumb through, or past,thumbprint reader 410. As is known in the art, the thumbprint reader 410may compare the user's thumbprint to stored thumbprints, or may compareportions of the user's thumbprint, such as specific swirls, whorls, orpatterns within a thumbprint, to previously recorded thumbprintportions. Alternatively, if a user is utilizing the kiosk system for thefirst time, thumbprint reader 410 may record the user's thumbprint, orportions thereof, for future security-related comparisons.Alternatively, an electronic finger-print identification system may besubstituted in a community-based health information and screening kiosksystem in place of thumbprint reader 410.

Card reader 405 may be located on the left side of the user-desk portion400 of the kiosk system. Card reader 405 may be one or several types ofcommercially available card readers. Card reader 405 may be able to readmagnetic stripe cards that store information/data on a band of magneticmaterial on the back of the card, such as a credit card or someidentification cards, or may be able to read cards carryinginformation/data in the form of bar coding.

The overall system may be capable of creating user-specific health kioskcards. The system may be able to print out a health kiosk card for auser that stores (magnetically, by bar code, or by an alternative datastorage system known in the art) identifying information and the user'sPHR. Card reader 405 may be capable of reading the user's data off oneof these health kiosk cards, so that a specific user may easilytransport his or her PEAR from one kiosk to another. Such a card canalso act as an additional form of identification for security purposes.

Camera 407 may be located above user display screen 406. Camera 407 maybe a commercially available digital or analog video recording devicecapable of capturing static images as well as full motion video. Incertain embodiments, camera 407 may be mounted on the end of a flexibleand adjustable cable and be capable of being pulled out by a user. Fiberoptic cables can allow for this sort of flexibility and adjustabilityand may be appropriate. For example, if a remote health careprofessional wishes to see a close-up image of a user's ailment, theuser may be able to pull out camera 407 to give the health careprofessional a better image of the patient.

The main purpose of camera 407 is to capture still and motion images ofa user, which are then transmitted to remotely located health careprofessionals. Still and/or motion images of the user may also be storedand incorporated into the user's PHR or for any other suitable purpose.User image 202 in FIG. 2 illustrates the view that a remotely locatedhealth care professional could see of the kiosk user.

User display screen 406 is located at the approximate center of verticalpanel 412 of the user desk portion 400 of the kiosk system. User displayscreen 406 may be a standard video monitor capable of displaying fullcolor still images and/or full motion video. In a preferred embodiment,user display screen 406 is a 15 to 17 inch color monitor with a touchscreen. Touch screen capability allows a user to input selections andmanipulate data by directly touching the screen, as opposed to having touse a mouse or keyboard to make on-screen selections, as is known in theart. A standard personal computer mouse (not shown) may be incorporatedinto systems not utilizing a touch screen.

Speaker 415 may be located anywhere on the kiosk system, so long as auser seated in user seat 502 of FIG. 5 is able to hear the audioemanating from speaker 415. As will be further shown in FIG. 5, use ofthe speaker 415 may be limited, however, in order to prevent someonefrom overhearing the questions being asked of the user and/or the user'sanswers when being provided or providing personal information. A privacybutton is provided on the vertical panel 412, on the touch screen 406,or elsewhere within the kiosk system, to enable a user to switch fromverbal communication via the speaker 415 and a microphone to the headset401 or a traditional telephone headset (not shown). In a preferredembodiment, speaker 415 may be located on the left side of verticalpanel 412 of the user desk portion 400 of the kiosk system.Alternatively, more than one speaker may be used. For example, twospeakers, one on each side of user display screen 406, may be used toprovide stereo sound to a user. Speaker 415 may be any sort ofcommercially available audio speaker capable of playing audio soundsproduced by the kiosk system. Speaker 415 may be configured so that whena user plugs headphones or a headset 401 into the kiosk system, speaker415 automatically mutes so audio only is played through the headphonesor headset 401. Alternatively, the software platform may provide a userwith various audio options, including allowing audio to play boththrough headphones/headset and through speaker 415. Those skilled in theart will recognize the various audio arrangements that are possible whena kiosk system is configured with both headphones/headset 401 capabilityand speaker 415 capabilities.

The following devices, and other similar devices, may be referred to asmedical diagnostic devices, as they are used to record, measure, and/oranalyze the user's health. Pulse oximeter 409 may be located near thebottom of vertical panel 412, to the right of keyboard 403. Pulseoximeter 409 should be located so that a user can easily insert his orher finger into the pulse oximeter while seated normally at the kiosksystem. A pulse oximeter is a device used to indirectly measure theoxygen saturation of a user's blood (as opposed to measuring oxygensaturation directly through a blood sample) and changes in blood volumein the skin. Pulse oximeter 409 may be used to produce aphotoplethysmograph (a possible output format of a pulse oximeter),which may be incorporated into the user's PHR, transmitted to remotelylocated health care professional, or otherwise stored and used asappropriate. Most commercial pulse oximeter devices clip onto a user'sfinger and send data through wires running back towards the user andalong the user's arm. Pulse oximeter 409 may be designed so that itswiring runs back into and is communicatively coupled with the kiosksystem away from the user.

A temperature sensor 414 is provided in the upper right portion of thevertical panel 412, but could be located elsewhere. Any one or more of anumber of different temperature sensors 414 could be used, such as acontact sensor that infers the temperature of a user that contacts thesensor, or a noncontact sensor that might use an infrared sensors orsome other form of sensors to detect the temperature of a user inproximity of the sensor.

Blood glucose meter port 416 may be located anywhere on the kiosksystem. In a preferred embodiment, blood glucose meter port 416 may belocated below the temperature sensor 414 on the right side of verticalpanel 412 of the user desk portion 400 of the kiosk system. Bloodglucose meter port 416 is capable of linking to standard commercialblood glucose meters through interface hardware in the port, which maybe situated on a cable to make it easier to connect to a meter. When auser hooks his or her blood glucose meter into blood glucose meter port416, the data stored on the blood glucose meter is transferred into thekiosk system, where it can be incorporated into the user's PHR,transmitted to remotely located health care professionals, or stored andanalyzed as appropriate. It is also possible to include a non-invasiveblood glucose meter in the kiosk system, so that a user does not have toprovide his or her own blood glucose meter.

Blood pressure cuff test interface 504 is not clearly seen in FIG. 4,but is illustrated in FIG. 5. Blood pressure cuff test interface 504 ispositioned on the left side of the kiosk system, so that a user caneasily slip his or her arm through the cuff while seated on the seat 502of the kiosk system. Blood pressure cuff test interface 504 is capableof measuring and analyzing a user's blood pressure and heart rate. Theblood pressure cuff test interface 504, in combination with the overallkiosk system, utilizes a measurement algorithm based on a plurality ofmeasurements, providing a unique ability to increase diagnostic andanalytical success in detection.

In an illustrative implementation, three measurement techniques are usedin combination to improve overall measurement accuracy. A first of thethree techniques is an auscultatory technique. A sound measurementacquired from a microphone located in the measurement cuff detects startand end Korotkoff sounds using a combination of filters. Theauscultatory technique is a conventional method that is recommended bythe American Heart Association and is similar to manual techniques usedby a health care professional. The auscultatory technique and associatedfiltering techniques are well known by those having ordinary skill inthe art. A second technique is an oscillometric technique that iscommonly found in many low-cost blood pressure measurement devices. Apressure cuff is used to measure pressure oscillations, which aredetected and monitored using mean pressure, and systolic and diastolicpressure ratios to identify systolic and diastolic blood pressure. Athird technique, called a pattern recognition technique, measures asound envelope and incorporates pattern recognition to identify systolicand diastolic pressures. The pattern recognition technique uses 1,000sound impressions per second, or between 40,000 and 60,000 soundimpressions per test. A signal from the pressure sensor is used inaddition to the three techniques to quantify the regions of sound underanalysis. The precise blood pressure cuff test interface apparatus andmethods of use are described in Bluth et al., U.S. Pat. No. 6,511,435,which is incorporated herein by reference.

The blood pressure and heart rate data obtained by use of blood pressurecuff test interface 504 may be utilized in much the same way as otherdata collected from a user by the kiosk system. Such data can beutilized to perform a health risk assessment for the user, can beincorporated into the user's PHR, can be transmitted to remotely locatedhealth care professionals, can be transmitted to various medicalresearch databases in a non-personally-identifiable format, and/or canbe stored locally and analyzed as appropriate.

User seat 502 is shown in FIG. 5. In a preferred embodiment of the kiosksystem, user seat 502 is slideably-mounted to the left side of the kiosksystem. User seat 502 is capable of sliding underneath the user-deskportion of the kiosk system so that a user in a wheelchair is able toput his or her wheelchair into position so as to use the kiosk system.As user seat 502 is slideable, it may be adjustable to several differentpositions at varying distances from the user desk portion 400 of thekiosk system. Alternatively, user seat 502 may be capable of continuousmovement and placement at any practical distance from user desk portion400. User seat 502 may additionally be equipped with a scale toaccurately measure a user's weight, as described in Bluth et al., U.S.Pat. No. 6,403,897, which is incorporated herein by reference. In thissituation, the scale of user seat 502 is communicatively coupled to thekiosk system so that either digital or analog weight data can beutilized to perform a health risk assessment for the user, can beincorporated into the user's PHR, can be transmitted to remotely locatedhealth care professionals, can be transmitted to various medicalresearch databases in a non-personally-identifiable format, and/or canbe stored locally and analyzed as appropriate. The precise weight-scaleuser seat apparatus and methods of use are described in Bluth et al.,U.S. Pat. No. 6,403,897, which is incorporated herein by reference.

In addition to the various non-invasive health diagnostic input devicesdescribed above (question-and-answer input, visual input, verbal input,pulse oximeter input, blood glucose input, blood pressure and heart rateinput, weight input, etc.), the kiosk system can also include invasivetesting. For example, cholesterol testing, urine testing, and bloodtesting can be administered to a user by the kiosk system, with the helpof licensed health care professionals (nurses, technicians, etc.). Suchtests require a licensed professional to assist the user and to carrierout the test. Tools and supplies needed for these invasive tests can bestored on shelving units which may be built into the back side (notshown) of the kiosk system. A nurse or other licensed health careprofessional can administer the invasive test and then can inputresults, which may be referred to as invasive testing information,manually (via keyboard 403, via keyboard 303, or via touch-screenoptions). An invasive testing system used to analyze the invasivelycollected fluids can be connected to an additional port at the back ofthe kiosk system, or send its results over the network 108 to the kiosksystem.

As previously noted, the kiosk system may also include several devicesthat can be described as output devices, such as a printer, as opposedto the various health diagnostic input devices. FIG. 5 includes a paperslot 506 in which paper output by a printer incorporated into the kiosksystem is accessible by a user. The output paper may include printedanswers to health assessment questions, results of various tests, asummary of information provided by the user, and many other types ofdata. FIG. 3 also illustrates a plan view of a triage version of thekiosk system that includes various output devices.

In FIG. 3, flatbed scanner 305 is located on the top of the kiosksystem. Flatbed scanner 305 is communicatively coupled to the kiosksystem, so that documents and information scanned in by a user is inputinto the system. Flatbed scanner 305 can be any type of commerciallyavailable scanner capable of receiving hard copy documents andconverting them into electronically transferable images or electronicdocuments. For example, a user may be able to scan in his or her healthinsurance card, identification or other documentation. The kiosk systemsoftware platform may be able to recognize certain information containedwithin the scanned-in documents—such as the user's social securitynumber, for example—and fill in various forms automatically. Forexample, scanned-in medical records could be automatically incorporatedinto the user's PHR and/or be transmitted to a remotely located healthcare professional. Flatbed scanner 305 may be located on top of thekiosk, or may be embedded within a top portion of the kiosk system on aslideable tray, somewhat above where a seated user's head would normallybe located, so that a user can slide flatbed scanner 305 out for use andthen slide it in, and out of the way, after use. Alternatively, thescanner could be located on the front of the kiosk system, such asscanner 507 of FIG. 5. In such a situation, the scanner 507 might beplaced on a tray that can slide out from the front of the kiosk systemand be more readily accessible by users.

Printer 304 may also be located on top of the kiosk system, as isillustrated in FIG. 3. Alternatively, as previously noted, printer 304may be embedded within an upper portion of the kiosk system, in such away as to eject printed sheets of paper through a printer-eject slot 506somewhat above where a seated user's head would normally be located.Printer 304 may be a standard commercial printer (laser, ink-jet, orother presently available technology) capable of printing eitherblack-and-white documents, or full color documents. Alternatively incertain situations such as in triage, printer 304 may be a label-makerspecifically designed to print-out situation-specific labels for use asuser (patient) identifiers.

The kiosk system is designed to provide a user with a secure and privateexperience despite the fact that the kiosk system may be located in avery public space, such as a store, waiting room, office complex, etc.Privacy for the user is very important because a user may use the hereindisclosed kiosk system to engage in personal medical discussions with aremotely located health care professional. Providing the user with aprivate setting will enable the user to feel completely comfortablediscussing and listening to personal health care information. To furtherenhance the privacy of the setting, the kiosk system may include aprivacy curtain 508, illustrated in FIG. 5, which can fully enclose theuser during use of the kiosk system. Privacy curtain 508 slides alongprivacy track 510 to form a barrier between a user seated within thekiosk system and the surrounding room in which the kiosk system islocated. Privacy curtain 508 may be designed to automatically move alongprivacy track 510 after a user sits down on the seat 502 at the kiosksystem and engages the kiosk software platform. Alternatively, privacycurtain 508 may be designed to close after a user presses an appropriatebutton (not shown) on the user desk portion 400, or makes an appropriateselection within the software platform by touching an on-screen buttonor clicking of a computer mouse. Privacy curtain 508 would likewise openwhen the user has finished using the kiosk system, which may beindicated by selecting an appropriate physical button within the kiosk,selecting a software button, finishing a test or procedure, or gettingup from the seat 502. The material of the privacy curtain 508 should beformed of any material that would help to reduce sound emanating fromwithin the kiosk system during use so as to provide a user with agreater degree of privacy.

The kiosk system may also include a safety feature for disengaging in anemergency situation. For example, a hardware button may be included onthe user desk portion 400 of the kiosk system that when pressedautomatically releases a user's arm from blood pressure cuff testinterface 504, and automatically opens privacy curtain 508, so that theuser can quickly leave the kiosk system. FIG. 4 illustrates such ahardware release button 417 positioned on the right side of verticalpanel 412 of the user desk portion 400 of the kiosk system.Alternatively, a software platform button or on-screen option may beavailable to the user that will quickly and automatically release theuser's arm from blood pressure cuff test interface 504 and/or openprivacy curtain 508. A similar hardware release button can be located onthe back side of the kiosk system to allow a health care professional toquickly and automatically disengage blood pressure cuff test interface504 and/or privacy curtain 508.

An additional privacy-enhancing feature of the herein disclosed kiosksystem is the third-party display screen 512 illustrated in FIG. 5.Third-party display screen 512 is located on the side of the kiosksystem, preferably near the top of the kiosk system so as to be easilyviewable from some distance away. Third-party display screen 512 is avideo monitor capable of displaying still images and full-motion video.Third-party display screen 512 may be a standard 15 to 17 inch monitormuch like user display screen 406, or it may be different—smaller orbigger. The purpose of third-party display screen 512 is two-fold.First, to provide marketing and/or educational health-relatedinformation to persons in the vicinity of the kiosk system other thanthe immediate user seated within the kiosk system. For example,third-party display screen 512 may be connected to a DVD player and mayplay repeated loops of various health-related advertisements.Alternatively, third-party display screen 512 may display information onhow to use the kiosk, or how to find a doctor in that particulargeographic location. Third-party screen 512 may also be linked to thenetwork 108 and therefore may be capable of streaming advertisementsand/or informational feeds from any available Internet sources. A kiosksystem may be equipped with several of these third-party displaymonitors, on various sides of the kiosk system, so that multiplemessages may be displayed.

Third-party display screen 512 may include one or more speakers foremitting audio related to the video images displayed on screen. Audiorelated to the health information/advertisements establishes the secondpurpose of the third-party display screens, to provide a counter-pointvisual and audio stimulus that distracts anyone outside of the kiosksystem from being able to hear or pay attention to any sound emanatingfrom a user's use of the kiosk system. If someone other than the user isin close proximity to the kiosk, they would likely be distracted byimages and sounds being generated, and therefore less likely to overheara user consulting with a remotely located doctor.

While the present inventions have been illustrated and described hereinin terms of a preferred embodiment and several alternatives associatedwith community-based health information and screening kiosk systems, itis to be understood that the various components of the combination andthe combination itself can have a multitude of additional uses andapplications. For example, the kiosk systems herein disclosed can easilybe adapted to other settings or uses. Accordingly, the inventions shouldnot be limited to just the particular descriptions and various drawingfigures contained in this specification that merely illustrate one ormore preferred embodiments and applications of the principles of theinvention.

It should be apparent that the examples discussed above are onlypresented as examples. The various user-accessible menus, buttons, andinterfaces are only one way to accomplish the more generally describedsystems, methods, apparatuses, and computer programs. For example, wherecertain features or user options are described as buttons, it may beapparent to those skilled in the art that the same function can beaccomplished by using radio buttons, drop-down menus, or check-box-typeoptions instead. All such available possibilities are intended to becovered by this specification.

Finally, it should be noted that where this specification describes asystem for obtaining health information and screening, it is intended tocover related methods of utilizing the kiosk systems.

1. A managed health system, comprising: a user input and display systemincluding a user display screen displaying a health assessmentquestionnaire to a user and two or more input devices receiving one ormore pieces of health information and one or more pieces of personalidentification information from the users and receiving a completedquestionnaire based on the user's input to the health assessmentquestionnaire, and including a first network connection transmitting thecompleted questionnaire, the one or more pieces of health informationand the one or more pieces of personal identification information; and ahealth care professional input and display system including a secondnetwork connection receiving the completed questionnaire, the one ormore pieces of health information, and the one or more pieces ofpersonal identification information, a health care professional displayscreen displaying the completed questionnaire, the one or more pieces ofhealth information, and the one or more pieces of personalidentification information, and two or more health care professionalinput devices receiving one or more health care professionalauthorizations based on a health care professional's assessment of thecompleted questionnaire and the one or more pieces of healthinformation, the one or more health care professional authorizationtransmitted by the second network connection.
 2. The system as recitedin claim 1, wherein the two or more health care professional inputdevices include a health care professional keyboard and a health careprofessional signature pad.
 3. The system as recited in claim 1, whereinthe two or more health care professional input devices and the healthcare professional display screen are included in a stand-alone PC. 4.The system as recited in claim 1, wherein the two or more health careprofessional input devices and the health care professional displayscreen are included in a laptop PC.
 5. The system as recited in claim 1,further comprising a printer communicatively coupled to the firstnetwork connection, wherein the first network connection receives theone or more health care professional authorizations, wherein the userinput and display system generates a situation-specific user-identifyinglabel based on the one or more pieces of personal identificationinformation and the health care professional's assessment of thecompleted questionnaire and the one or more pieces of health informationafter the first network connection receives the one or more health careprofessional authorizations, and wherein the situation-specificuser-identifying label is printed by the printer.
 6. The system asrecited in claim 5, wherein the user input and display system furtherdetermines a triage assessment for the user based upon the completedquestionnaire, the one or more pieces of health information and the oneor more pieces of personal identification information, and wherein thesituation-specific user-identifying label includes the triageassessment.
 7. The system as recited in claim 6, wherein the firstnetwork connection transmits the triage assessment to the health careprofessional input and display system for display, wherein the one ormore health care professional authorizations are further based on ahealth care professional's assessment of the triage assessment, whereinthe one or more health care professional authorizations include a triageassessment sign-off, and wherein the printer will not print thesituation-specific user-identifying label including the triageassessment before the health care professional input and display systemreceives the triage assessment sign-off.
 8. The system as recited inclaim 7, further comprising a storage system communicatively coupled tothe first network connection and the second network connection andsecurely receiving and storing the one or more pieces of healthinformation, the one or more pieces of personal identificationinformation, the completed questionnaire, the health care professional'sassessment and the triage assessment in a personal health record.
 9. Thesystem as recited in claim 8, wherein the storage system is distributedover one or more hubs and a copy of the personal health record is storedat each of the one or more hubs.
 10. The system as recited in claim 1,further comprising a storage system communicatively coupled to the firstnetwork connection and securely receiving and storing the one or morepieces of health information and the one or more pieces of personalidentification information in a personal health record.
 11. The systemas recited in claim 10, wherein the personal health record furtherincludes the completed questionnaire and the health care professional'sassessment.
 12. A managed health system, comprising: a kiosk system,including a user input and display system communicatively coupled to ahealth care professional input and display system, the user input anddisplay system having a user display screen displaying a healthassessment questionnaire to a user, two or more input devices receivingone or more pieces of health information from the user, one or morepieces of personal identification information from the user, and acompleted questionnaire based on the user's input to the healthassessment questionnaire, and transmitting the completed questionnaire,the one or more pieces of health information, and the one or more piecesof personal identification information, the health care professionalinput and display system, having a health care professional displayscreen, receiving and displaying the completed questionnaire, the one ormore pieces of health information and the one or more pieces of personalidentification information from the user, having two or more health careprofessional input devices receiving one or more health careprofessional authorizations based on a health care professional'sassessment of the completed questionnaire and the one or more pieces ofhealth information, and transmitting the health care professional'sassessment and the one or more health care professional authorizations;a storage system communicatively coupled to the kiosk system andsecurely receiving and storing the one or more pieces of healthinformation, the one or more pieces of personal identificationinformation, the completed questionnaire, the health care professional'sassessment and the one or more health care professional authorizationsfrom the kiosk system in a personal health record for the user; and aprinter communicatively coupled to the kiosk system and printing asituation-specific user-identifying label based on the one or morepieces of personal identification information, the health careprofessional's assessment of the completed questionnaire and the one ormore pieces of health information.
 13. The system as recited in claim12, wherein the kiosk system further determines and transmits a triageassessment for the user based upon the completed questionnaire, the oneor more pieces of health information and the one or more pieces ofpersonal identification information, and wherein the storage systemreceives and stores the triage assessment in the personal health record.14. The system as recited in claim 13, wherein the health careprofessional display screen further displays the triage assessment, andwherein the health care professional authorizations include a triageassessment sign-off.
 15. The system as recited in claim 14, wherein theprinter will not print the situation-specific user-identifying labeluntil the triage assessment sign-off has been generated.
 16. A managedhealth system, comprising: a kiosk systems including a user input anddisplay system communicatively coupled to a health care professionalinput and display system, the user input and display system having auser display screen displaying a health assessment questionnaire to auser, two or more input devices receiving one or more pieces of healthinformation from the user, one or more pieces of personal identificationinformation from the user, and a completed questionnaire based on theuser's input to the health assessment questionnaire, and transmittingthe completed questionnaire, the one or more pieces of healthinformation, and the one or more pieces of personal identificationinformation to the health care professional input and display system,the health care professional input and display system having a healthcare professional display screen receiving and displaying the completedquestionnaire, the one or more pieces of health information and the oneor more pieces of personal identification information from the user,having two or more health care professional input devices receiving oneor more health care professional authorizations based on a health careprofessional's assessment of the completed questionnaire and the one ormore pieces of health information, determining a triage assessment forthe user based upon the one or more pieces of health information, theone or more pieces of personal identification information, and thehealth care professional's assessment, and transmitting the triageassessment; a storage system communicatively coupled to the kiosk systemand securely receiving and storing the one or more pieces of healthinformation, the one or more pieces of personal identificationinformation, and the triage assessment from the kiosk system in apersonal health record; and a printer communicatively coupled to thekiosk system and printing a situation-specific user-identifying labelbased on the triage assessment.
 17. The system as recited in claim 16,wherein the situation-specific user-identifying label is further basedon the one or more pieces of personal identification information, theone or more pieces of health information and the health careprofessional's assessment.
 18. A method for developing a triageassessment of a user, comprising the steps of: receiving one or morepieces of health information from the user through a kiosk systemequipped with a display and two or more input devices; receiving one ormore pieces of personal identification information from the user throughthe two or more input devices; displaying a health assessmentquestionnaire to the user; receiving a completed questionnaire based onthe user's input to the health assessment questionnaire through at leastone of the two or more input devices; and generating the triageassessment from a health care professional based on the one or morepieces of health information, the one or more pieces of personalidentification information, and the completed questionnaire.
 19. Themethod of claim 18, wherein the kiosk system is further equipped with asecond display, further comprising the step of displaying the one ormore pieces of health information, the one or more pieces of personalidentification information and the completed questionnaire to the healthcare professional on the second display and receiving the triageassessment from the health care professional through the two or moreinput devices.
 20. The method of claim 18, further comprising the stepof printing a situation-specific user-identifying label based on thetriage assessment, the one or more pieces of personal identificationinformation, the health care professional's assessment of the completedquestionnaire, and the one or more pieces of health information.
 21. Themethod of claim 18, further comprising the step of storing the one ormore pieces of health information, the one or more pieces of personalidentification information, and the triage assessment in a personalhealth record associated with the user.